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Autonomic Effects of Spironolactone and MR Blockers in Heart Failure

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Abstract

Neurohormonal dysfunction is an important and potentially modifiable part of the disease process of heart failure. In this review we will discuss the ways in which the autonomic system is deranged in congestive cardiac failure and the different ways we have of monitoring these abnormalities i.e.: heart rate variability, plasma norephinephrine activity, MIBG scanning, heart rate turbulence, baroreceptor function and briefly, microneurographic techniques and QT interval analysis. We will then discuss the direct effects of aldosterone and of aldosterone blockade on some of these parameters. We conclude that neurohormonal dysfunction is an important component of chronic heart failure, which is affected by aldosterone and can be modified by the use of aldosterone receptor blockade.

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Authors and Affiliations

  1. Department of Clinical Pharmacology, Division of Medicine, Dundee, Scotland, DD1 9SY

    Justine I. Davies MRCP & Allan D. Struthers FRCP

  2. Department of Ageing and Health, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY

    Miles D. Witham MRCP

  3. Department of Clinical Pharmacology Division of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY

    Justine I. Davies MRCP

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  1. Justine I. Davies MRCP
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  2. Miles D. Witham MRCP
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  3. Allan D. Struthers FRCP
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Correspondence to Justine I. Davies MRCP.

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Davies, J.I., Witham, M.D. & Struthers, A.D. Autonomic Effects of Spironolactone and MR Blockers in Heart Failure. Heart Fail Rev 10, 63–69 (2005). https://doi.org/10.1007/s10741-005-2350-4

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  • DOI: https://doi.org/10.1007/s10741-005-2350-4

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